1. Field of the Invention
The present invention relates broadly to surgical devices. More particular, the present invention relates to orthopedic bone plates, particularly for fracture fixation. Additionally, the present invention relates to orthopedic bone plates having suture connectors, loops, receptacles or members thereon.
2. Description of Related Art Including Information Disclosed Under 37 CFR 1.97 and 37 CFR 1.98.
The proximal humerus comprises the upper portion of the humerus (i.e. upper arm of the human body) and forms a portion of the shoulder joint. Fractures of the proximal humerus typically result from traumatic injury, such as sporting accidents, and can be frequent with age due to bone loss. Fractures of the proximal humerus are treated by exposing the fracture site and reducing the bone fracture and then placing a plate onto the bone to fixate the fracture for healing in the reduced position. Reducing the fracture includes realigning and positioning the fractured portions of the bone to their original position or similar stable position. Fixating the fracture includes positioning a plate over the fractured portion and then securing the plate onto the fractured bones and adjacent non-fractured bones with bone screws. Commonly, after a fracture, there exists disassociated tuberosities at the proximal portion of the humerus. Tuberosities are pieces of bone with tendons attached. The bone is weak, but the insertion points of the tendons are very strong. The accepted way to reattach the bone for healing is to use suture material to stitch into the insertion point of the tendon and pull down to anchor the bone with the suture.
Humeral plates often include suture holes at which suture material, e.g. braided cord or wire suture, can secure the tuberosity to the plate. The suture holes are generally circular holes extending transverse to the longitudinal axis of the plate. For example, the Philos™ plate by Synthes includes multiple suture holes displaced around the plate which extend between the bone contacting and lower plate surfaces. Because one opening of each suture hole is even with the bone-contacting surface, access to or egress from the holes is impeded.
Various patents have issued and patent publications have published relating to such bone fixation plates. For example, U.S. Patent Publication No. 2006/0100623, published on May 11, 2006 to D. Pennig, describes a system for fixation of bone fractures. In particular, this is a system for improving the fixation of proximal fractures of the humerus. This system includes at least one humeral nail that is inserted in a humeral shaft. There are several and proximal transversal holes for the passage of corresponding locking screws. At least one screw of the locking screws has a screw head and a screw body. An intermediate plate element is inserted between the screw head and the bone cortex surface so that the head is abutting against the plate. The intermediate plate element is slightly bent to adhere substantially to the bone cortex surface. The intermediate plate element has a couple of elongated arm portions that are inserted in an astride position on the screw body before the final fastening of the screw head.
U.S. Patent Publication No. 2006/0241617, published on Oct. 26, 2006 to Holloway et al., provides a bone plate with suture loops. The suture loops are flexible and formed of a strong suture material. The suture loops may have various shapes, forms and configurations. These suture loops are provided on the bone plate in locations depending on the characteristics of the fractured bone or bone segment. Preferably, the suture loops are attached to a surface of the bone plate. The suture loops serve to receive a strand of suture for fixation of soft tissue to the bone plate.
U.S. Pat. No. 7,604,657, issued on Oct. 20, 2009 to Orbay et al., teaches a bone fixation plate with complex suture anchor locations. This fracture fixation system includes a plate having a first suture anchor location having an opening at the upper surface of the plate, an opening at the proximal end of the plate, and an opening at the anterior side of the plate. First and second suture pathways are defined which cross within the plate. The first and second suture pathways include a common opening. A second suture anchor location on the plate has an opening at the upper surface of the plate, an opening at the proximal end of the plate, and an opening at the posterior side of the plate so as to define third and fourth suture pathways which cross within the plate. The third and fourth suture pathways also share a common opening. Each suture anchor location is capable of providing a hold for sutures from multiple approaches so as to secure tuberosities relative to the plate.
U.S. Pat. No. 6,096,040, issued on Aug. 1, 2000 to R. D. Esser, discloses an upper extremity bone plate. The first bone plate is configured and arranged to match the contour of a healthy unfractured proximal humerus. The bone plate includes an elongate shaft portion and a head portion. The shaft portion is adapted for receiving bone screws to fix the bone plate to a shaft of a humerus. The head portion includes a first head section and a second head section with an obtuse angle defined therebetween. The first and second head sections extend laterally away from a longitudinal axis of the shaft portion in generally opposite directions. The second head section is configured and arranged with a lateral portion to secure multiple fractures of a head of proximal humerus while extending laterally adjacent to the biceps tendon to preserve the tendon.
U.S. Patent Publication No. 2009/0326591, published on Dec. 31, 2009 to E. E. Spencer, teaches a system and method to position and secure fractured bones. In particular, this system is intended for reducing a proximal fractured humerus and includes a fracture reduction plate and an elongated pin including a plurality of threads. The elongated pin is configured to be inserted through the fracture reduction plate and engage with a humeral head. The fracture reduction plate is placed on the fractured humerus and provisionally secured. Sutures may be used to guide the fracture reduction plate into place on the fractured humerus. Next, the elongated pin is engaged with the humeral head at a superior angle relative to the humerus and the fracture is reduced. The elongated pin may be used to push the humeral head in a superior direction while pulling on the humeral head using the sutures. The fracture reduction plate can then be secured to the humerus and the elongated pin removed.
One of the difficulties associated with these prior art references is that the suture receptacles on the bone plate are generally in a fixed location. Depending upon the nature, shape, and size of the fracture of the proximal humerus, the desired locations for the suture retainers may significantly vary from that of the fixed positions of the prior art. As such, it is desirable to offer a bone plate in which the suture receptacle can be manipulated and positioned in a continuously variable manner around a surface of the bone plate. As a result, a surgeon would be able to properly position the suture receptacles in the most desirable position so as to achieve the proper suturing of the tuberosities.
It is an object of the present invention to provide a bone plate in which the suture receptacles can be positioned at various desirable locations around the bone plate.
It is another object of the present invention to provide a bone plate in which the suture receptacles can be locked in their desired positions prior to suturing.
It is another object of the present invention to provide a bone plate in which each of the suture receptacles offers a maximum amount of space so as to allow the suture to be easily introduced therein and therethrough.
It is still another object of the present invention to provide a bone plate with suture receptacles which is easy to use, relatively inexpensive and easy to manufacture.
These and other objects and advantages of the present invention will become apparent from a reading of the attached specification and appended claims.